Aarskog Nikolai Ravn, Bjørsrud Hanna Othilie Lindvig, Holten Aleksander Rygh, Watne Leiv Otto, Neerland Bjørn Erik, Rostrup Morten
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Acute Medicine, Division of Medicine, Oslo University Hospital, Oslo, Norway.
Sci Rep. 2025 Aug 3;15(1):28309. doi: 10.1038/s41598-025-13016-0.
Mountaineers with a high ventilatory response to hypoxia experience greater cognitive impairment at high altitude, possibly because hyperventilation causes hypocapnia, cerebral vasoconstriction and ultimately cerebral ischaemia. We hypothesised that a high ventilatory response, and consequently a lower arterial partial pressure of carbon dioxide (PaCO), could increase the risk of delirium in hospitalised patients with acute hypoxia. To test our hypothesis, we conducted a cohort study in which PaCO and arterial oxygen saturation were measured upon hospital admission in 126 patients with COVID-19. After adjusting for oxygen saturation, we found that a lower PaCO was associated with a higher risk of delirium during hospital admission (risk ratio 1.67 [95% confidence interval 1.09-2.54] per 1 kilopascal reduction, P = 0.017). The association remained statistically significant after adjusting for other well-established risk factors for delirium. This finding supports our hypothesis that a high hypoxic ventilatory response increases the risk of delirium in patients with acute hypoxia.
对低氧通气反应较高的登山者在高海拔地区会出现更严重的认知障碍，这可能是因为过度通气会导致低碳酸血症、脑血管收缩并最终导致脑缺血。我们推测，高通气反应以及由此导致的较低动脉血二氧化碳分压（PaCO）可能会增加急性低氧血症住院患者发生谵妄的风险。为了验证我们的假设，我们进行了一项队列研究，对126例新冠肺炎患者入院时的PaCO和动脉血氧饱和度进行了测量。在调整血氧饱和度后，我们发现较低的PaCO与住院期间发生谵妄的较高风险相关（每降低1千帕斯卡，风险比为1.67[95%置信区间1.09 - 2.54]，P = 0.017）。在调整了其他已确定的谵妄风险因素后，该关联仍具有统计学意义。这一发现支持了我们的假设，即高缺氧通气反应会增加急性低氧血症患者发生谵妄的风险。
